Recruitment in Child Psychiatry: The Impact of a Voluntary Fellowship Program on Medical Students Career Decisions

by Arzubi, Eric

Abstract (Summary)

This study was designed to measure interest in child and adolescent psychiatry
among medical students and to assess the impact of an innovative medical student
fellowship program on that interest.
Students (N = 916) from ten medical schools completed an online survey
designed to measure their interest in child and adolescent psychiatry and their
understanding of the subspecialty. Students (N = 123) participating in a voluntary child
and adolescent psychiatry fellowship offered at six of the ten medical schools completed
an online survey designed to evaluate the quality of their experience and to measure the
impact of the fellowship program on their understanding of the subspecialty and on their
interest in becoming child and adolescent psychiatrists.
There exists relatively low interest in pursuing a career in child and adolescent
psychiatry among medical students in general, with 79% of fellowship non-participants
stating that they have ruled out a career in the subspecialty. Medical students also
indicated they had limited knowledge of the field, with 61% of non-fellows stating that
they had little or no understanding of child and adolescent psychiatry. Conversely,
medical students who did report a strong understanding of child and adolescent
psychiatry were much more likely to show interest in pursuing a career in the field. The
fellowship was rated highly by participating medical students, with 83% of participants
rating the experience Good or Excellent; the fellowship appeared to make its biggest
impact on students understanding of the subspecialty, with 53% indicating that their
understanding was greatly increased. The fellowship program succeeded in strengthening
a strong initial interest in a child and adolescent psychiatry career among medical
students. 62% of participants said they joined the fellowship program in part because
they were already considering a career in the subspecialty, and 64% of students continued
to express that interest after taking part in fellowship activities. 22% of participants
stated the fellowship program greatly increased their desire to become child and
adolescent psychiatrists.
Given the high prevalence of pediatric mental disorders, a closer look at the state
of child and adolescent psychiatry education and recruitment is warranted. Psychiatric
disorders are among the most frequently diagnosed medical conditions in children and
adolescents, and there is a shortage of clinicians who are equipped to treat them. Only
2% of medical students indicated a very strong understanding of child and adolescent
psychiatry and 1% of medical students expressed a maximal interest in pursuing a career
in the subspecialty. Medical education must prepare primary care physicians, many of
whom will encounter a significant number of pediatric patients with mental illness, to
properly assess and treat them. Moreover, leaders in child and adolescent psychiatry
must continue improving existing recruitment initiatives. Until medical school curricula
include more teaching of child development and psychopathology, the fellowship can
prove to be an effective vehicle through which to teach medical students about child and
adolescent psychiatry. The fellowship is particularly effective as the program provides
medical students with opportunities to work directly with children and their families in
clinical settings and in schools. That exposure, coupled with effective mentoring
relationships, has turned the fellowship into an effective recruitment tool for child and
adolescent psychiatry.